Our aim in this study was to describe adolescent girls' circumstances underlying the decision to resort to unsafe induced abortions. Thirty-four Zambian girls aged 13 to 19 years admitted to University Teaching Hospital (UTH) in Lusaka were interviewed using a semistructured questionnaire with both closed and open-ended questions. Results revealed that most of the girls were single, in school, reached higher grades, mainly nulliparous, and had very low knowledge of contraceptive use. Reasons given for performing unsafe abortions were fear of facing personal shame and social stigma following premarital pregnancies, such as parental disapproval, abandonment by partner, and expulsion from school. A blend of traditional and modern methods and medicines were used to abort. Limited access to contraception and the stigma attached to premarital pregnancies and abortions are likely to continue to compel girls to rely on clandestine abortions if comprehensive adolescent reproductive health services are not provided. The necessity to give adolescent girls more attention and advocacy is obvious.